title: Bibliographic review of research publications on access to and use of medicines in low-income and middle-income countries in the Eastern Mediterranean Region: identifying the research gaps.
abstract: OBJECTIVE
  We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.
  
  
  METHODS
  Bibliographic review of published studies.
  
  
  METHODS
  LMICs in EMR.
  
  
  METHODS
  Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.
  We conducted comprehensive searches of the PubMed, Social Science Citation Index and Science Citation Index. We used the WHO ATM framework for data extraction and synthesis. We analysed the data according to the ATM issues, health system levels, year of publication and the countries of origin or focus of the studies.
  
  
  RESULTS
  151 articles met the inclusion criteria. Most articles (77%) originated from LMICs in EMR, suggesting that the majority of evidence on ATM in the region is home-grown. Over 60% of articles were from Iran, Pakistan, Jordan and Lebanon (in order of volume), while we found no studies assessing ATM in Somalia, Djibouti and South Sudan, all low-income countries. Most studies focused on the rational use of medicines, while affordability and financing received limited attention. There was a steady growth over time in the number of ATM publications in the region (r=0.87).
  
  
  CONCLUSIONS
  There is a growing trend, over the years, of more studies from the region appearing in international journals. There is a need for further research on the financing and affordability aspects of ATM in the region. Cross-border issues and the roles of non-health sectors in access to medicines in the region have not been explored widely.
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Rashidian
authors.forename: Nader
authors.initials: N
authors.lastname: Jahanmehr
authors.forename: Samer
authors.initials: S
authors.lastname: Jabbour
authors.forename: Shehla
authors.initials: S
authors.lastname: Zaidi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Soleymani
authors.forename: Maryam
authors.initials: M
authors.lastname: Bigdeli
keywords: EPIDEMIOLOGY; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PUBLIC HEALTH